As illuminated by the implementation of the Affordable Care Act individual mandate, health insurance in the United States remains mostly a state or regional issue. Just one look at the Marketplace on healthcare.gov will illustrate that market offerings, plan organization types, and prices vary widely in different regions.
But why? How about instituting a federal insurance regulatory body to uphold uniform regulations for a national market, abolishing state run insurance regulatory agencies, and letting insurers sell their product wherever they can find a willing consumer base?
Commerce clause should allow for this reform.